Whether it’s a routine checkup or an appointment to address a specific health concern, it’s common that your doctor requests a lab work up. In fact, physicians recommend lab work 50 percent of the time. It’s not likely, however, that you comparison-shopped for which lab they sent you to. But this choice can influence the cost and quality of your service.
In-network, out-of-network, PAR and non-PAR are important terms to understand to help keep your health care costs down. Before you or your doctor schedules a lab test, like a complete blood count (CBC) or biopsy, make sure you know these three things.
- Participating (PAR) labs
The term PAR lab is the same as saying the lab is in-network. This means the lab has an agreement with your insurance company to participate in the health plan network and charge a lower set rate for services in exchange for your health plan’s business. Choosing a PAR lab helps ensure your receiving quality services at a lower cost to help avoid surprises on your bill.
- Non-participating (non-PAR) labs
Out-of-network labs is the same as non-par labs. This is when labs have not entered an agreement with your insurance payer. This may leave a lot of uncertainty when it comes to the cost and quality for services, because the pricing can have a large range.
Non-PAR labs may charge roughly 6-10 times more, depending on the situation and you won’t always see this price difference on your bill, but the high cost from non-PAR labs add to the cost of your health insurance.
- Preferred lab network (PLN)
UnitedHealthcare launched the preferred lab network last summer to help make it easier for doctors and patients to find labs that commit to improving cost, health outcomes and the patient experience. Access to labs and services didn’t change, but members who stay in the PLN will experience the most cost savings.
For example, pathology services for a biopsy in the PLN could cost about $89. Members could still choose an in-network lab, but the cost could increase to nearly $151. An out-of-network lab could cost even more, at $196.
How to know if your lab is par, non-par or part of PLN
If you are a UnitedHealthcare member, you can look up par labs in the Rally directory. Within this directory is a designation for the PLN.
Currently, AmeriPath/DermPath, BioReference, GeneDx, Invitae, LabCorp, Mayo Clinic Laboratories and Quest Diagnostics are part of the PLN. These labs were selected based on a rigorous quality review process. These are subject to change annually on July, 1. Check the directory to confirm.